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amifostine

Generic Name: amifostine (AM i FOS teen)
Brand Name: Ethyol

What is amifostine?

Amifostine is used to help lessen the side effects of certain cancer chemotherapy medications or radiation treatment.

Amifostine is used to protect the kidneys from harmful effects caused by cisplatin when given to patients with ovarian cancer.

Amifostine is also used to prevent severe dry mouth caused by radiation treatment of the head and neck, which can affect the salivary gland.

Amifostine will not prevent all side effects of chemotherapy medications. However, this medicine may help protect your body from some of the serious side effects that chemotherapy can cause.

Amifostine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amifostine?

Avoid taking blood pressure medication within 24 hours before you receive amifostine.

What should I discuss with my healthcare provider before receiving amifostine?

You should not be treated with amifostine if you are allergic to it, or if:

  • you are dehydrated; or

  • you have taken blood pressure medication in the past 24 hours.

You will need to stop taking any blood pressure medication for at least 24 hours before you are treated with amifostine. Talk with your doctor if you are concerned about stopping your blood pressure medication for a short time.

To make sure amifostine is safe for you, tell your doctor if you have ever had:

  • kidney disease;

  • low blood pressure;

  • high blood pressure;

  • low levels of calcium in your blood (hypocalcemia);

  • heart disease or prior heart attack; or

  • a stroke (including "mini-stroke").

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether amifostine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How is amifostine given?

Amifostine is injected into a vein through an IV. A healthcare provider will give you this injection.

Amifostine is usually given within 15 to 30 minutes before the start of radiation or chemotherapy.

You may need to drink extra liquids before you receive amifostine. Follow your doctor's instructions.

You may be given other medications to prevent nausea or vomiting while you are receiving amifostine.

To be sure this medication is not causing harmful effects, your blood pressure will be watched closely while you are receiving amifostine.

If you stopped taking blood pressure medicine the day before your amifostine infusion, your caregivers will continue to check your blood pressure for a short time after your infusion.

Your doctor may ask you to take a calcium supplement while you are receiving amifostine. Take only the amount of calcium your doctor recommends.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your chemotherapy or radiation treatment.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving amifostine?

Avoid taking blood pressure medication within 24 hours before you receive amifostine.

Avoid getting up too fast from a sitting or lying position after your amifostine infusion, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Amifostine side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using amifostine.

Tell your caregivers right away if you have:

  • severe or ongoing vomiting;

  • a light-headed feeling, like you might pass out;

  • weak or shallow breathing;

  • chest pain, fast or slow heart rate;

  • a seizure; or

  • redness, rash, or blisters on the palms of your hands or the soles of your feet.

Common side effects may include:

  • nausea, vomiting;

  • flushing (warmth, redness, or tingly feeling);

  • fever, chills, general ill feeling;

  • rash;

  • dizziness, drowsiness;

  • hiccups, sneezing;

  • blurred vision, double vision; or

  • pain, itching, redness, bruising, or swelling around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Amifostine dosing information

Usual Adult Dose for Non-Small Cell Lung Cancer:

To reduce the cumulative renal toxicity associated with repeated administration of cisplatin: 910 mg/m2 administered once daily as a 15 minute IV infusion, starting 30 minutes prior to chemotherapy.

The 15 minute infusion is better tolerated than more extended infusions. Further reductions in infusion times for chemotherapy regimens have not been systematically investigated.

Patients should be adequately hydrated prior to amifostine infusion and kept in a supine position during the infusion. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated.

The infusion of amifostine should be interrupted if the systolic blood pressure decreases significantly from the baseline value as listed in the guideline below:
1) baseline systolic blood pressure is <100 mm Hg and decreases by 20 mm Hg during treatment
2) baseline systolic blood pressure is 100-119 mm Hg and decreases by 25 mm Hg during treatment
3) baseline systolic blood pressure is 120-139 mm Hg and decreases by 30 mm Hg during treatment
4) baseline systolic blood pressure is 140-179 mm Hg and decreases by 40 mm Hg during treatment
5) baseline systolic blood pressure is >=180 mm Hg and decreases by 50 mm Hg during treatment

If the blood pressure returns to normal within 5 minutes and the patient is asymptomatic, the infusion may be restarted so that the full dose of amifostine may be administered. If the full dose of amifostine cannot be administered, the dose of amifostine for subsequent chemotherapy cycles should be 740 mg/m2.

It is recommended that antiemetic medication, including dexamethasone 20 mg intravenously and a serotonin 5-HT3 receptor antagonist, be administered prior to and in conjunction with amifostine. Additional antiemetics may be required based on the chemotherapy drugs administered.

Usual Adult Dose for Ovarian Cancer:

To reduce the cumulative renal toxicity associated with repeated administration of cisplatin: 910 mg/m2 administered once daily as a 15 minute IV infusion, starting 30 minutes prior to chemotherapy.

The 15 minute infusion is better tolerated than more extended infusions. Further reductions in infusion times for chemotherapy regimens have not been systematically investigated.

Patients should be adequately hydrated prior to amifostine infusion and kept in a supine position during the infusion. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated.

The infusion of amifostine should be interrupted if the systolic blood pressure decreases significantly from the baseline value as listed in the guideline below:
1) baseline systolic blood pressure is <100 mm Hg and decreases by 20 mm Hg during treatment
2) baseline systolic blood pressure is 100-119 mm Hg and decreases by 25 mm Hg during treatment
3) baseline systolic blood pressure is 120-139 mm Hg and decreases by 30 mm Hg during treatment
4) baseline systolic blood pressure is 140-179 mm Hg and decreases by 40 mm Hg during treatment
5) baseline systolic blood pressure is >=180 mm Hg and decreases by 50 mm Hg during treatment

If the blood pressure returns to normal within 5 minutes and the patient is asymptomatic, the infusion may be restarted so that the full dose of amifostine may be administered. If the full dose of amifostine cannot be administered, the dose of amifostine for subsequent chemotherapy cycles should be 740 mg/m2.

It is recommended that antiemetic medication, including dexamethasone 20 mg intravenously and a serotonin 5-HT3 receptor antagonist, be administered prior to and in conjunction with amifostine. Additional antiemetics may be required based on the chemotherapy drugs administered.

Usual Adult Dose for Malignant Disease:

For reduction of moderate to severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer, where the radiation port includes a substantial portion of the parotid glands:
The recommended dose of amifostine is 200 mg/m2 administered once daily as a 3 minute intravenous infusion, starting 15 to 30 minutes prior to standard fraction radiation therapy (1.8-2.0 Gy).

Patients should be adequately hydrated prior to amifostine infusion. Blood pressure should be monitored at least before and immediately after the infusion, and thereafter as clinically indicated.

It is recommended that antiemetic medication be administered prior to and in conjunction with amifostine. Oral 5-HT3 receptor antagonists, alone or in combination with other antiemetics, have been used effectively in the radiotherapy setting.

What other drugs will affect amifostine?

Taking any drugs that can lower your blood pressure may cause dangerous side effects while you are receiving amifostine.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • an antidepressant;

  • heart or blood pressure medication;

  • medicine for erectile dysfunction;

  • medicine to treat Parkinson's disease; or

  • opioid (narcotic) medication.

This list is not complete. Other drugs may interact with amifostine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about amifostine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03.

Last reviewed: November 09, 2017
Date modified: December 03, 2017

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